1. Field of the Invention
This invention relates generally to protective shoulder pads such as those worn by individuals participating in athletic activities. In particular, this invention improves currently available protective shoulder pads with a feature that allows emergency medical personnel or others to safely and easily remove the protective shoulder pads from the individual wearing the shoulder pads in case of suspected neck or cervical spine injury.
2. Description of the Related Art
Protective shoulder pads are commonly used by athletes and other individuals to protect the individual's shoulders, chest, upper and lower back, and upper arms from impact that may result in injury. For example, protective shoulder pads are utilized in sports where collision is inherent and produces a significant risk of injury, such as football and hockey. However, individuals wearing protective shoulder pads are generally reluctant to use protection for the fragile neck and upper spine because this protection significantly diminishes the mobility that athletes and other individuals desire. As a result, the neck and upper spine are more susceptible to injury than other parts of the human body.
When such neck or cervical spine injuries occur, protective shoulder pads themselves become a risk factor for iatrogenic injury during the course of initial medical evaluation and management. Currently available protective shoulder pads only allow removal as an entire unit. The proper technique for protective shoulder pad removal includes one member of the medical team maintaining manual stabilization of the athlete's head and neck at all times. While that member of the medical team remains in place manually stabilizing the head and neck, the injured athlete's torso is elevated to a 30-40 degree angle by flexing the athlete's lower spine and hips. While in this compromised position, the protective shoulder pads are then maneuvered in a manner to remove them, essentially, over the head of the injured athlete. This maneuver is extremely complicated and may potentially cause a secondary injury. Research in the field of spinal cord injury has demonstrated up to 25% of cervical spinal cord injured patients experience neurologic deterioration during the course of initial evaluation and management.
In the event that an individual suffers a suspected injury to the spine or neck, the current practice in the medical profession is to stabilize the individual in the supine position while diagnosing and treating the individual. The National Athletic Trainers' Association's guidelines and recommendations in this field, Prehospital Care of the Spine-Injured Athlete, require that any athlete who is suspected of having a head and/or spinal injury should be managed as though a spinal injury exists, and if unconscious, the player is presumed to have an unstable fracture until it is proved otherwise. The guidelines further state that the improper management of a suspected spinal injury can result in a secondary injury. Head and shoulder stabilization must be maintained during any manipulation and removal of equipment to avoid cervical movement, lateral flexion and other movements which could lead to further injury.
While providing stabilization to the wearer's spine, the protective shoulder pads must be removed from the injured athlete while lying supine to aid in the diagnosis and treatment of a suspected cervical spine or neck injury. The current National Athletic Trainers' Association's guidelines and recommendations require at least four individuals to remove currently available shoulder pads. Realizing the importance of limiting the amount of unnecessary movement during this process to prevent a secondary injury, the guidelines recommend removing the protective shoulder pads only to an extent that full access to chest, face, neck, and arms may be accessed. The National Athletic Trainers' Association's suggested method comprises the steps of cutting all soft clothing and soft portions of the shoulder pads with a knife or equivalent cutting apparatus as required to spread the two anterior halves of the protective shoulder pads that are currently available. However, the repositioning of the protective shoulder pads to this limited extent precludes sufficient access to the neck and cervical spine areas that medical personnel must access to diagnose and treat an individual with a suspected cervical spine injury.
Recent unpublished studies by Rechtine and Horodysky at the University of Rochester have demonstrated significant motion in the cervical spine during shoulder pad removal despite the utilization of optimal techniques that are currently recommended by national athletic training and trauma specialty organizations. The consequences of such motion may include loss of one or more levels of neurological function in the acute spinal cord injured athlete. This alone could result in a potentially ambulatory athlete becoming non-ambulatory, an independent athlete becoming dependent, or an athlete who may have independent respiration becoming respirator dependent. The human cost and the cost to society of such deterioration are enormous. No current protective shoulder pad design allows for the safe removal of the protective shoulder pads from an individual immobilized in the supine position by less than four properly trained people. Furthermore, current protective shoulder pad designs prevent both stabilization of the potentially injured athlete and an acceptable quality of radiographic imaging.
In their article Helmet and Shoulder Pad Removal in Football Players with Unstable Cervical Spine Injuries, M. C. Dahl, D. Ananthakrishnan, G. Nicandri, and R. P. Ching, the authors, while recognizing that “patient handling is often impaired due to the protective equipment worn and improper stabilization of these patients can exacerbate neurologic injury,” the authors discussed alternative methods for removing protective shoulder pads and the resulting detriments caused by each method. The levitation technique was found to produce motion in the anterior and right lateral directions. The tilt technique resulted in motions in the posterior left lateral directions, and the log roll technique generated motions in the right lateral direction and had the largest amount of increased instability when comparing the intact and lesioned specimen. According to the authors, “these findings suggest that each method of equipment removal displays unique weaknesses that the practitioner should take into account.”
In another study, the amount of motion that occurred during protective shoulder pad removal in a cadaver with an injured spine was evaluated and quantified. Helmet and shoulder pad removal from a player with suspected cervical spine injury. A cadaveric model Spine. W F Donaldson, W C Lauerman, B Heil, R Blanc, T Swenson. 1998. The authors of the study concluded that shoulder pad removal in the unstable cervical spine is a complex maneuver, and that because of the motion observed in the unstable spine, shoulder pad removal should be performed in a carefully monitored setting by at least three, preferably four, trained people.
Another problem with currently available shoulder pads is that different types of protective shoulder pads are available for specific purposes, and the different types exacerbate the problems in removing the shoulder pads. Specific models of protective shoulder pads have posterior portions of the shoulder pads that protect down to the small of the user's back. The injured athlete must be moved to a greater degree to remove the shoulder pads, thus increasing the potential for a secondary injury. The weight of the wearer's torso exerted on the posterior member of the shoulder pads prevents easy removal of the shoulder pads, and as discussed, it is undesirable to move the individual wearing the protective shoulder pads. Another complication of attempting to remove protective shoulder pads over the head of an individual is the weight and mass of the individual. Large and heavy individuals are more difficult to lift and their body mass proves detrimental to the removal of the protective shoulder pads, thus requiring more movement of the individual and increasing the potential for a secondary injury in a person with a suspected neck or cervical spine injury.
Thus, existing protective shoulder pads become an impediment to diagnosing and treating an individual while in the supine position and the removal of the shoulder pads may potentially cause a secondary injury. The removal of the protective shoulder pads requires significant movement of the wearer by at least four trained medical personnel. While the prior art of protective shoulder pads satisfactorily reduces the risk of injury to the individual's shoulders, chest, upper and lower back, and upper arms, no protective shoulder pad is available that allows for removal of the shoulder pads and allows for sufficient access to the wearer's neck and spine while maintaining the neck and spine in a neutral position while in the supine position.
These improved protective shoulder pads provide a solution to the challenges of diagnosing and treating suspected neck and spinal injuries. By allowing the removal of the shoulder pads while maintaining the neck and spine in the neutral position, these improved shoulder pads substantially eliminate the risk of further injury to an individual wearing shoulder pads with a suspected neck or spinal injury. The benefit of these improved protective shoulder pads is the ease and effectiveness of removal of those portions of the protective shoulder pads that typically present obstacles to the effective diagnosis and treatment. Once these portions are removed, medical personnel can more effectively diagnose and treat the individual suspected of a cervical spine or neck injury. The release mechanisms for the protective shoulder pads address the risk of increasing neurologic injury in the spinal cord injured athlete by eliminating the spinal motion demonstrated by Rechtine during shoulder pad removal. The invention provides for removal of the shoulder pads by simple release mechanisms which are easily accessible by first responders and medical professionals. Once the protective shoulder pads are safely removed, the injured athlete's spine becomes readily accessible for stabilization and radiographic evaluation.